Estimating mean circulatory filling pressure in clinical practice: a systematic review comparing three bedside methods in the critically ill.

The bedside hemodynamic assessment of the critically ill remains challenging since blood volume, arterial-venous interaction and compliance are not measured directly. Mean circulatory filling pressure (Pmcf) is the blood pressure throughout the vascular system at zero flow. Animal studies have shown Pmcf provides information on vascular compliance, volume responsiveness and enables the calculation of stressed volume. It is now possible to measure Pmcf at the bedside. We performed a systematic review of the current Pmcf measurement techniques and compared their clinical applicability, precision, accuracy and limitations. A comprehensive search strategy was performed in PubMed, Embase and the Cochrane databases. Studies measuring Pmcf in heart-beating patients at the bedside were included. Data were extracted from the articles into predefined forms. Quality assessment was based on the Newcastle-Ottawa Scale for cohort studies. A total of 17 prospective cohort studies were included. Three techniques were described: Pmcf hold, based on inspiratory hold-derived venous return curves, Pmcf arm, based on arterial and venous pressure equilibration in the arm as a model for the entire circulation, and Pmcf analogue, based on a Guytonian mathematical model of the circulation. The included studies show Pmcf to accurately follow intravascular fluid administration and vascular compliance following drug-induced hemodynamic changes. Bedside Pmcf measures allow for more direct assessment of circulating blood volume, venous return and compliance. However, studies are needed to determine normative Pmcf values and their expected changes to therapies if they are to be used to guide clinical practice.

On being grateful and kind: results of two randomized controlled trials on study-related emotions and academic engagement.

Despite the large amount of research attention to engagement as well as positive psychology in a general context, there have been few attempts to increase academic well-being by means of positive psychological interventions. This article tests the potential of positive psychological interventions to enhance study-related positive emotions and academic engagement, and to reduce study-related negative emotions among university students. We modified two existing positive interventions that are aimed at increasing general happiness for use in an academic context. These interventions focused on "thoughts of gratitude" and "acts of kindness," respectively. The present study consisted of two randomized controlled trials with experimental (thoughts of gratitude or acts of kindness) and control conditions in which participants were monitored on a daily basis during the one-week intervention, and additional pre-, post-, and follow-up assessments were carried out. Results revealed that the gratitude intervention had a significant positive effect on daily positive emotions only. The kindness intervention had a positive influence on both positive emotions and academic engagement, though not in the long run. The results showed no effects on negative emotions in either of the two interventions. Positive psychological interventions seem to foster positive emotions and academic engagement, but do not decrease negative emotions.

Believe, and you will achieve: changes over time in self-efficacy, engagement, and performance.

In order to answer the question whether changes in students' self-efficacy levels co-vary with similar changes in engagement and performance, a field study and an experimental study were conducted among university students. In order to do this, we adopted a subgroup approach. We created "natural" (Study 1) and manipulated (Study 2) subgroups based upon their change in self-efficacy over time and examined whether these subgroups showed similar changes over time in engagement and performance. The results of both studies are partly in line with Social Cognitive Theory, in that they confirm that changes in self-efficacy may have a significant impact on students' changes in cognition and motivation (i.e. engagement), as well as behavior (i.e. performance). More specifically, our results show that students' increases/decreases in self-efficacy were related to corresponding increases/decreases in their study engagement and task performance over time. Examining the consequences of changes in students' self-efficacy levels seems promising, both for research and practice.

Watching the paint dry at work: psychometric examination of the Dutch Boredom Scale.

Boredom at work is a state of employee unwell-being that is characterized by relatively low arousal and high dissatisfaction. At present little is known about boredom at work. In order to facilitate future research, the current study introduces a brief self-report questionnaire that assesses boredom at work, the Dutch Boredom Scale (DUBS). We argue that (1) boredom at work can be distinguished empirically from related concepts such as work engagement and job burnout; (2) boredom at work results from having an unchallenging, "passive" job; and (3) the subsequent lack of challenge in the form of boredom may result in dissatisfaction with the job and with the organization. Using data from 6315 employees, factor analysis supported the factorial and discriminant validity of the DUBS vis-à-vis engagement and burnout. As expected, structural equation modeling revealed that demands and resources were negatively associated with boredom. Moreover, boredom at work was negatively related with job satisfaction and organizational commitment, and positively with turnover intention. These findings support the validity of the DUBS. Future research may focus on underemployment as an antecedent of boredom at work, and on the effects of boredom on job performance.